LOS ANGELES COUNTY COMMISSION ON HIV HEALTH SERVICES 3530 Wilshire Boulevard, Suite 1140 Los Angeles, CA TEL (213) FAX (213)

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1 LOS ANGELES COUNTY COMMISSION ON HIV HEALTH SERVICES 3530 Wilshire Boulevard, Suite 1140 Los Angeles, CA TEL (213) FAX (213) While not required of meeting participants, signing-in constitutes public notice of attendance. Presence at meetings is recorded solely based on sign-in sheets, and not signing-in constitutes absence for Committee members. Only members of the Commission on HIV Health Services are accorded voting privileges, thus Commissioners who have not signed in cannot vote. COMMISSION MEETING MINUTES September 9, 2004 MEMBERS PRESENT MEMBERS ABSENT OTHERS PRESENT OAPP STAFF Al Ballesteros, Co-Chair Anthony Braswell Cinderella Barrios-Cernik Kyle Baker Nettie DeAugustine, Co-Chair Carrie Broadus Elissa Bradley Jay Gabor Ruben Acosta Charles Carter Donna Brown Michael Green Adrian Aguilar Nancy Eugenio Gordon Bunch Raymond Johnson Carla Bailey William Fuentes Molly Flaherty Jan King Mark Briggs Alexander Gonzales Alex Garcia David Pieribone Robert Butler Rebecca Johnson-Heath Miki Jackson Diana Vasquez John Caranto Marcy Kaplan Luis Lopez Juhua Wu Ruth Davis Michael Lewis Ruel Nolledo Richard Eastman Elizabeth Marte Brenda Padilla Whitney Engeran Chris Perry Rich Platt Hugo Farias Alexis Rivera Jane Price Gunther Freehill Mark Parra Sherry Rolls Michael Gray Fontaine Shockley Natalie Sanchez David Giugni Fariba Younai D. Turman John Griggs Maribel Ulloa Richard Hamilton Gary Vrooman COMMISSION STAFF Charles Henry Jan Wise and CONTRACTORS Wilbert Jordan Patricia Woody Virginia Gomez Brad Land/Dean Page Marc Haupert Anna Long Jane Nachazel Andrew Ma James Stewart Elizabeth Mendia Craig Vincent-Jones Vicky Ortega Nicole Werner John Palomo Virginia Gomez Dana Pierce-Hedge Wendy Schwartz Vanessa Talamantes Kevin Van Vreede Kathy Watt I. CALL TO ORDER: Ms. DeAugustine called the meeting to order at 9:51 am. Self-introductions were made. II. APPROVAL OF AGENDA: The agenda was approved. MOTION #1: Motion passed by consensus. III. APPROVAL OF MEETING MINUTES: The August 12, 2004 meeting minutes were approved. MOTION #2: Motion passed by consensus. IV. PARLIAMENTARY TRAINING: Mr. Stewart had no report.

2 Page 2 of 6 V. PUBLIC COMMENT, NON-AGENDIZED: No public comment. VI. CO-CHAIRS S REPORT: A. Annual Meeting: The Annual Meeting dates were re-confirmed for November 8 and 9, 2004, after Ms. DeAugustine noted that it would conflict with the American Public Health Association (APHA) Conference the same week. Ms. DeAugustine asked for volunteers for an Annual Meeting workgroup and Mssrs. Butler, Page and Land volunteered to participate in order to discuss issues such as the venues and other conference logistics. VII. OAPP REPORT: Mr. Henry welcomed Dr. Jan King as OAPP s new Medical Director, and Jay Gavore, a Graduate Fellow from New York who will be working at OAPP for the next nine months. Mr. Henry also reported that OAPP released two Requests for Proposals (RFP) for Substance Abuse and Residential Services on August 23, 2004; due on September 24, He further went on to say that he presented the Mercer unit cost development approach with Ashish Abraham and John Villegas-Grubbs (from Mercer Consulting Group) at the All Titles meeting in Washington, DC, August 23-25, He thanked the Commission for its support and for allocating resources to conduct these kinds of studies. Mr. Henry added that some community discussion was suggested that the Commission is de-funding housing services in South Los Angeles, to which he responded there are a number of providers in the area that he expected would continue providing services in the future. Mr. Henry noted that the State Office of AIDS had been coordinating periodic meetings with the State s nine Title I EMAs, which Mr. Vincent-Jones and Ms. DeAugustine have attended in the past. Michael Montgomery and Ms. Pierce-Hedge have both provided a lot of leadership convening the nine EMAs to focus on two topics: 1) how to develop a model to estimate the unmet need consistent with CARE Act requirements; 2) to develop and foster a position from the State s EMAs regarding CARE Act Reauthorization from the perspective of how different various changes might affect resources to California. He added the Mr. Freehill and Laura Thomas from San Francisco gave an overview presentation of the CARE Act. He pointed out that the group had requested that Northern California Grantmakers film the presentation so the information can be shared with other California EMAs. A. CARE Act: An Overview : Mr. Freehill then made the following presentation Mr. Freehill reviewed changes that have occurred in the CARE Act over the course of the past 14 years. Mr. Freehill was asked to clarify the words rural and remote. He explained that rural areas are those locales in which there is an extremely low population density, whereas remote areas are characterized as population centers of any size that are vast distances from the larger urban area. For example: some Northern California counties are considered rural, while the Antelope Valley and outlying areas are remote. Dr. Jordan asked how the needs of transgenders have been addressed. Mr. Freehill responded that the have never been part of the actual law. VIII. HIV EPIDEMIOLOGY PROGRAM REPORT: Mr. Bunch reported that two studies that had been traditionally used for both care and prevention planning were terminated by the CDC: SHAS (Supplement to HIV AIDS Surveillance) and ASD (Adult Spectrum of HIV-Related Disease Study) at the end of June. CDC terminated these studies because they both had significant limitations and they were going to replace them with the Multiple Morbidity Monitoring Project and Risk Behavior Surveillance studies. Mr. Bunch noted that HIV Epi had applied for and received an award to continue the new study designs. He added that HIV Epi had also submitted a simultaneous application under the same program to help assess unmet need, but it was not funded. HIV Epi received a one-time allocation of Net County Cost (NCC) funding to continue the engagement of several HIV reporting public health investigative staff. On September 21, 2004 they will present a request to the Board to extend the funding thru March IX. STATE OFFICE OF AIDS (OA) REPORT: Ms. Pierce-Hedge reported that the State Office of AIDS is satisfied with the ADAP budget. The Therapeutic Monitoring Program (TMP) was restored with an addition $3 million from the State s General Fund. The State is currently negotiating with specific labs to come to begin conducting resistance testing and are hoping to get those agreements signed by September 30, 2004 for viral load testing in the EIPs (Early Intervention Program sites). She added that there should be enough carry-over funds for the Care HIPP Program through April. She went on to say that the next meetings with all of the State s EMAs will be in October.

3 Page 3 of 6 XI. STANDING COMMITTEE REPORTS: A. Recruitment, Diversity and Bylaws (RD&B) Committee 1. Candidate Evaluation Procedure: Mr. John Palomo reported they have worked on this for several weeks, have made several revisions and asked for approval of the proposed policy and procedure. MOTION #3: Motion passed by consensus. 2. Membership Recruitment: Mr. Butler reminded everyone to complete their applications and send in any endorsements and/or letters of recommendations that might need to be included for consideration. He added that they would like to have them by September 17, Mr. Butler explained that the entire process takes approximately 60 days: once the Committee reviews the application, their recommendations go to the Commission for consideration and then to the Board for appointment. They are aiming for recommendations by the October Commission meeting, but will not guarantee them by then. He further explained that when a member of the RD&B Committee s application is reviewed, that individual is required to leave the room. Mr. Stewart clarified that when the nominations came to the Commission, it did not represent a conflict to vote in favor of a slate on which a voting Commissioner s name appears along with others. B. Joint Public Policy (JPP) Committee 1. By-law Modification: Mr. Engeran forwarded a motion to make a bylaw modification essentially disbanding the Public Policy Committee s Joint relationship with the Prevention Planning Committee. Mr. Briggs expressed concern that communication between the two bodies would be interrupted if the change were made. Ms. Talamantes reported that the PPC had approved a similar motion to dissolve the Joint Public Policy Committee, and that, for the PPC, all prevention policy issues would be addressed by its Executive Committee for the time being. MOTION #4: Motion passed. 2. Commercial Sex Venue (CSV) Guidelines: Mr. Engeran shared that he and Mr. Vincent-Jones spoke at the recent Board meeting on behalf of the Commission and in support of the guidelines. The Ordinance passed with some minor changes: instructing County departments to report back on some technical provisions, such as criminal background checks for owners or operators, and doors being left on or off private rooms. Mr. Engeran said he felt that the Public Policy Committee no longer had a role or needed to take any further action as the Commission has made its views clear. Mr. Henry clarified that the new Ordinance identifies sex clubs as a distinct type of venue, as the old Ordinance did not. There is some exclusion for hotels and motels: if their primary purpose was to act as a sex venue, they would probably be covered by the new Ordinance. 3. Names-Based HIV Surveillance: Mr. Engeran announced that there will be two Community Education Forums on the topic on September 14 and 15, He added that both Being Alive Los Angeles and AHF had requested time on the agenda. Mr. Vincent-Jones said that the second forum would be video-taped for use by some other Counties. Dr. Jordan expressed some concern that people making the presentations were not familiar to the communities. Mr. Engeran explained that committee members, people living with HIV and all persons of color sitting on the Committee will be at the forums and will be able to make their opinions clear. Mr. Hamilton added that it has been very challenging to get the community to attend these forums; there is much misperception in the community about names-reporting, and he, for example, has had to explain to people that it does not mean that people s names will be published in newspapers. Mr. Aguilar asked if it would be possible to do one of these forums in Spanish. He and Ms. Talamantes volunteered to work on organizing one. C. Standards of Care (SOC) Committee 1. Managed Care Task Force: Mr. Ballesteros shared an outline of the Committee s previously approved Managed Care Task Force, the goals and the membership recommendations timeline and asked that the Commission approve it. MOTION #5: Motion passed by consensus 2. Rate Study Sequence: Mr. Vincent-Jones discussed the Standards Development and Review Timeline. It is an outline, month-by-month, which standards SOC intends to revise/develop in which order: once technical

4 Page 4 of 6 assistance is approved by HRSA. A few adjustments were made and a couple of categories were collapsed due to the priority- and allocation-setting process adjustments. SOC was asked by OAPP to prioritize the sequence of the next rate studies that will be conducted. This SOC proposal for that sequence was included. Mr. Henry requested that approval of the Rate Study sequence be held for the next meeting as he had not had a chance to review it. He asked for the opportunity for his staff to review it with Mercer. MOTION #6: Postponed for meeting in October. 3. Patients Bill of Rights: Dr. Jordan reported that OAPP had forwarded changes made to the Patients Bill of Rights on advice of County Counsel. Since those changes were minor, SOC was satisfied with the final document. Mr. Henry asked that the Commission come to a final approval on the document by the next meeting because OAPP was negotiating contracts. Mr. Vincent-Jones noted that the original motion had allowed for minor changes without requiring that the document be returned to the Commission for approval, and, thus, additional Commission approval was not necessary. D. Priorities and Planning (P&P) Committee: Mr. Land mentioned that the P&P Committee did not meet in August but was working on a number of projects: an IRB re-application for H-CAP; the Comprehensive Care Plan revisions, and analyzing final H-CAP data for the year. 1. Minority AIDS Initiative (MAI) Workgroup: the Priority- and Allocation-Setting process from the year before had called for a workgroup to review the Minority AIDS Initiative (MAI). Mr. Briggs, Ms. DeAugustine, Mr. Ballesteros, Mr. Hamilton, Dr. Jordan, Mr. Butler, and Ms. Broadus all volunteered. Mr. Land said that he hoped the group would begin meeting in late September early October. 2. Program Support Workgroup: Similarly, during the last Priority- and Allocation-Setting process, Mr. Land that another group to review program support was called for. Ms. DeAugustine, Mr. Butler and Mr. Acosta all volunteered for the group. Mr. Henry asked that the workgroups to indicate which dates they would need presentations well in advance. Mr. Vincent-Jones asked if OAPP would like to designate an OAPP representative for each workgroup. Mr. Henry concurred and said he would relay the names of those representatives to the Commission s Executive Director. E. Finance Committee Postponed XII. EXECUTIVE DIRECTOR S REPORT: A. Staffing Progress Mr. Vincent-Jones reported that the Commission had hired its new Planning Manager, Libby Boyce, from Public Health, and that she would be joining the office in mid -September. In addition, Sherry Rolls had been hired from HIV Epi, as the Planning Coordinator, and she would join the Commission effective September 20, He thanked the Commissioners for helping move this hiring process forward. He informed the Commission that St. Anne s has agreed to a reasonable monthly fee for Commission meetings, with an acceptable increase, and the Commission would continue to meet there. However, it is still a long-term goal to move the month Commission meetings to different SPAs throughout the year. He apologized that the Commission packet had not been made available to download this month, but the Monday holiday, lack of staff from the Executive Office, and some computer technical glitches made it impossible. Mr. Engeran asked for an update on the Website. Mr. Vincent-Jones explained that we are working with Internal Services Department (ISD) to confirm the new format and design. He explained that, now, the biggest challenge was for Commission staff to accumulate all of the required data and send it over to ISD to ready for publication. He added that the information cannot be sent piece-meal, and it is very time consuming with limited staff to prepare it properly. More staff that will help expedite the process soon. Ms. Watt mentioned that many of the Commissioners cannot download the packet. Mr. Vincent-Jones responded that staff will try to consider ways of prioritizing the information in a digestible form. XIII. PREVENTION PLANNING COMMITTEE (PPC) REPORT: Ms. Ortega reported that the CDC Project Officers at visited for the last PPC meeting. She mentioned that the previous Project Officer expressed that the PPC was one of the most mature and best prevention planning bodies in the nation.

5 Page 5 of 6 There was a presentation on the needs assessment project. The data collection process will continue in the month of September and October; PPC members were asked to sign up to be part of the recruitment process in several venues in Los Angeles. Ms. Talamantes invited everyone to participate in the project. PPC recommendations concerning CSV were forwarded to the Director of OAPP. If anybody is interested in finding out more the Materials Review Guidelines recommendations from the six most impacted jurisdictions in the nation, Ms. Talamantes indicated that people can log onto uchaps.com; other recommendations, including Los Angeles, are there as well. Mr. Butler asked if there is a draft of the Prevention Plan document available for PPC. Dr. Green gave an update that there is a second draft of the report and it is currently being circulated through OAPP for comment and will be available by the end of the week. At that time, it will go back to the contractor who is drafting the Prevention Plan for them and then it will go through another internal review before it goes for outside review. It will be completed by the end of the month and it will be available at the next Commission meeting. Mr. Henry requested that PPC do a summary presentation of the plan once it is finalized. Ms. Watt also said that there was a discussion on rapid testing, and how we address the mental health side of it. There were two representatives from the State that wanted to hear about about the mental health implications. They asked to work on the testing and counseling task force and come up with guidelines for the providers. XIV. COMMISSION COMMENT, NON-AGENDIZED: Mr. Engeran expressed the need to enhance the communication between Commission and HOPWA. He suggested that it should be discussed at the Executive Committee. Mr. Vincent-Jones reminded everyone that about a 1½ years ago, the Commission agreed to set up a HOPWA Task Force, and although staff has not had time to do it he we will make it a priority. He noted that Libby Boyce, due to her prior work, would play a key role in that task force. Mr. Land thanked John Schunhoff and Mr. Henry for going to Antelope Valley to celebrate the Hope Center s 10 th anniversary. He continued by thanking Mr. Vincent-Jones for his assistance in informing the various bodies in the community of the work of the Commission, such as names-reporting. Mr. Land announced that it was Kevin Van Vreede s last Commission meeting, thanked him for being very supportive as a member of the P&P Committee, and for his work with the Case Management Task Force. Mr. Ballesteros asked the Commission to look into the issue of lypodystrophy and people with long-term HIV. He has been in meetings where he has seen individuals with serious disfigurements. Although, it is not a CARE Act issue necessarily, it is an issue for people with HIV and there are just not enough resources out there addressing the need. XV. ANNOUNCEMENTS: Ms. Talamantes announced that Alta Med Health Services would be having their annual Noche de Esperanza (Night of Hope) fundraiser on September 25, 2004 at Paramount Studios. Mr. Vrooman, representative from HOPWA noted that the Connections demonstration project appears to be moving forward. Applications are available now at the HOPWA offices, and it will ultimately put 105 Section 8 vouchers on the street for people who are homeless and HIV+. These vouchers will keep people housed for 18 months. XVI. ADJOURNMENT: The meeting adjourned at 1:15 p.m.

6 Page 6 of 6 MOTION #1: Approve the Agenda Order. MOTION #2: Approve the minutes of the August 12, 2004 Commission on HIV Health Services meeting. MOTION #3: Approve the new Candidate Evaluation Policy, as presented. MOTION #4: Approve modification to Commission By-laws, separating the Joint Public Policy (JPP) Committee. MOTION #5: Approve the proposed Managed Care Task Force goals and plan. MOTION #6: Approve the revised Standards development timeline and proposed Rate Study sequence, as presented. MOTION AND VOTING SUMMARY Ayes: Butler, Caranto, Davis, DeAugustine, Eastman, Engeran, Farias, Briggs, Gray, Griggs, Jordan, Land, Ma, Mendia, Ortega, Palomo, Pierce-Hedge, Hamilton, Talamantes, Van Vreede, Watt No: Giugni, Ballesteros This item was held for the next Commission meeting in October. Ayes: 21 Opposed: 2 Abstentions: 0 Motion Postponed